- Information
- AI Chat
Maternal Health Notes – Week 3
Week 3 notes
Course
Maternal Care (NURS3023)
26 Documents
Students shared 26 documents in this course
University
The University of Notre Dame (Australia)
Academic year: 2022/2023
Uploaded by:
Anonymous Student
This document has been uploaded by a student, just like you, who decided to remain anonymous.
The University of Notre Dame (Australia)
Preview text
Maternal Health Notes – Week 3
Antenatal Care
Learning Objectives
- Define key terms
- Discuss the aims of antenatal care
- Calculate the EDB of pregnant women with a normal and short/long cycle.
- List frequently used investigations
- Identify the common discomforts of pregnancy, explain why these occur and describe the nursing interventions/actions to alleviate these
- Adapt and modify care planned for women with complexities in pregnancy
- Advise women on SIDS, alcohol and smoking in pregnancy
What is Antenatal Care?
- Care of the pregnant woman to: o Deliver a healthy term infant without impairing the woman’s health o Identify and optimally trat the high-risk pregnant woman
- By: o Screening symptomatic pregnant women o To detect and prevent both maternal and neonatal adverse events
Antenatal Care – Routine Visits for the Healthy Pregnant Woman
- Recommended schedule of visits o 4/52 to 28 weeks o 2/52 to 36 weeks o Weekly to term
Estimated Date of Birth
- A woman’s pregnancy lasts – 10 lunar months (or 280 days) being about 9 calendar months
- 40 week estimation o Developed by a German obstetrician, Naegele in the 1800s o Used the first day of the LMP as the starting point to calculate o Because conception typically happens 14 days after this time
Calculation of EDB Using Naegele’s Rule
- Based on a regular 28 day menstrual cycle
- Add 9 months + 7 days after the first day of the last normal menstrual period
Initial Antenatal Visit
- Baseline assessments o Physical, abdominal and breast examination o Record height, weight o BP o Urinalysis o Bloods FBC and Hb Blood group, Rh and atypical antibodies
VDRL screening (syphilis, chlamydia, gonorrhoea) HIV Screening
Health Promotion & Education
- Discussed at 1st or 2nd visit
- Model of care
- Immunity – rubella
- Breast care, breast self-examination
- Physiotherapy
- Antenatal classes
- Psychological support
- Social work, aboriginal liaison
- Dietary, including liaison
- Exercise
- Smoking
- Dental health
- Breastfeeding
- Timing of antenatal visits
Weight Gain in a Normal Pregnancy
- Normal weight gain for height: o About 10-16kg o Rough guide: 2-4kg in first 20 weeks, then 0 per week next 20 weeks
- Underweight women: eat more however must eat nutritiously
- Overweight women: eat less however must eat nutritiously
Nutritional Considerations in a Normal Pregnancy
- Diet o All food groups o May need more iron, calcium, vitamins
- Drinking o Thirst o Alcohol o Red bull
- Smoking
First Trimester – Maternal Screening
- Blood tests for: o Down’s syndrome – MMS (maternal serum screening) or triple test, not a diagnostic test assesses probability only – 70% sensitivity, 5% false-positive o Higher probability needs amniocentesis to diagnose
- Neutral tube defects
- Rubella titre
- Varicella titre
- Hep B, Hep C, HIV
Maternal Screening Test
Nuchal fold test – ultrasound, assesses risk of down syndrome
Skin pigmentation – face, nipples, areola, vulva, perineum & perianal linea alba linea nigra
Striae gravidarum
Pruritis gravidarum – alternation hepatic function
Varicose veins (progesterone & relaxin)
Low back pain (progesterone & relaxin) o Rise from lying position from a lateral position o Back and abdominal exercises, brace, physio o Avoid heavy lifting – including children
Cramp
Carpal tunnel syndrome
Symphysis pubic pain
Protecting the Unborn & Baby Born Baby
SIDS – Sudden Infant Death Syndrome
- Sudden, unexpected death of a baby <1 year of age, from no known cause
- Most common cause of death in babies 1 month – 1 year of age
- Most < 6 months
- Since (SIDS) prevention program) 1986 – 2005 90% decrease in incidence in Australia
- Deaths o 1986: 2/1, o 2005: 0/1, o 2014: 0/1, 000 o 2017: Annually- 3,200 Australian families experience the sudden & unexpected death of a baby/child.
SIDS Advice to Parents
- Safe cot, safe mattress, safe bedding
- Sleep baby on back from birth – baby overheats on tummy, suffocates
- Sleep baby with face and head uncovered – overheats, suffocates
- Sleep at the bottom of the cot (no soft toys)
- Keep baby out of smoky environment – don’t smoke before and after birth, risk doubles if mother smokes, doubles again if father is also, wear smoke free clothes, no smoking house/car
- Baby cot next to parents’ bed for 1st year of life o Safe cot, firm mattress, no bumpers, doonas, pillows o Do not sleep baby on lounge, on bed pushed against the wall
SIDS – Mechanism
- Hypothesis o Delayed arousal or cardio-respiratory control mechanism o Re-breathing hypoxia and hypercarbia (CO2) o Hyperthermia
- Parents worry o Flat head o Clothing – not overheat, SIDS more common in winter and cold countries o Dummies (pacifiers) safe o Wrap baby safely
Smoking During Pregnancy
- Cut down if smoker and pregnant
- Quit if contemplating pregnancy
- Dangers o Intrauterine growth restriction o Placental insufficiency o Foetal distress during labour o Premature birth o Breathing problems at birth o Feeding problems at birth o Feeding problems o Decreased IQ o Increased risk of SIDS
Alcohol in Pregnancy
- How much is ok?
- Effects of alcohol on the foetus increase o Smoke o Increase in caffeinated drinks o Underweight
- Foetal alcohol effects (2 units/day) o Decreased attention span o Behavioural problems o Hyperactivity
- Foetal alcohol syndrome (6 units/day) o Withdrawals o Mental and growth retardation o Behavioural problems o Heart defects o Decreased IQ o Delayed milestones
Was this document helpful?
Maternal Health Notes – Week 3
Course: Maternal Care (NURS3023)
26 Documents
Students shared 26 documents in this course
University: The University of Notre Dame (Australia)
Was this document helpful?
Maternal Health Notes – Week 3
Antenatal Care
Learning Objectives
1. Define key terms
2. Discuss the aims of antenatal care
3. Calculate the EDB of pregnant women with a normal and short/long cycle.
4. List frequently used investigations
5. Identify the common discomforts of pregnancy, explain why these occur and describe the
nursing interventions/actions to alleviate these
6. Adapt and modify care planned for women with complexities in pregnancy
7. Advise women on SIDS, alcohol and smoking in pregnancy
What is Antenatal Care?
- Care of the pregnant woman to:
oDeliver a healthy term infant without impairing the woman’s health
oIdentify and optimally trat the high-risk pregnant woman
- By:
oScreening symptomatic pregnant women
oTo detect and prevent both maternal and neonatal adverse events
Antenatal Care – Routine Visits for the Healthy Pregnant Woman
- Recommended schedule of visits
o4/52 to 28 weeks
o2/52 to 36 weeks
oWeekly to term
Estimated Date of Birth
- A woman’s pregnancy lasts – 10 lunar months (or 280 days) being about 9 calendar months
- 40 week estimation
oDeveloped by a German obstetrician, Naegele in the 1800s
oUsed the first day of the LMP as the starting point to calculate
oBecause conception typically happens 14 days after this time
Calculation of EDB Using Naegele’s Rule
- Based on a regular 28 day menstrual cycle
- Add 9 months + 7 days after the first day of the last normal menstrual period
Initial Antenatal Visit
- Baseline assessments
oPhysical, abdominal and breast examination
oRecord height, weight
oBP
oUrinalysis
oBloods
FBC and Hb
Blood group, Rh and atypical antibodies
